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1.
Objective: To investigate the association between concentrations of soluble intercellular adhesion molecule-1 (ICAM-1) and interferon-γ (IFN-γ) with regard to the severity of endometriosis. Design: Cross-sectional study. Setting: Infertility unit in a university hospital. Patient(s): Seventy-one infertile patients who underwent laparoscopic evaluation were divided into two groups: 36 patients with endometriosis served as cases, and 35 patients without endometriosis served as control subjects. Intervention(s): Peripheral blood and peritoneal fluid (PF) were collected from these patients during laparoscopic examination. Main Outcome Measure(s): Quantitative determination of levels of human ICAM-1 and IFN-γ was performed with the use of an ELISA. The data were evaluated by Student’s t-test, analysis of variance, and regression analysis. Result(s): Significantly elevated levels of soluble ICAM-1 were found in the sera of patients with endometriosis, especially those with advanced stages of the disease. Decreased IFN-γ levels, which were negatively correlated with serum levels of soluble ICAM-1, also were noted in the PF of patients with endometriosis. Conclusion(s): The increased serum levels of ICAM-1 found in patients with endometriosis may indicate the presence of an active disease process. Further, the increased levels of soluble ICAM-1 in peripheral blood were inversely correlated with the concentrations of IFN-γ in PF. The increased levels of soluble ICAM-1 in plasma may be associated with an immunologic feedback response that blocks further infiltration of immune cells. These findings may be of value in the diagnosis and evaluation of endometriosis. 相似文献
2.
目的 测定子宫内膜异位症患者血清中可溶性细胞间粘附分子 - 1(sICAM - 1)、可溶性白细胞介素Ⅱ受体 (sIL - 2R)的水平 ,并探讨其临床意义。方法 应用酶联免疫吸附试验双抗体夹心法 (ELISA)对 2 3例子宫内膜异位症患者及 17例正常妇女血清sICAM - 1、sIL - 2R水平进行测定。结果 术前子宫内膜异位症患者血清中sICAM - 1、sIL - 2R水平明显高于正常对照组 (P <0 0 1)。轻度组与重度组之间无显著性差异 (P >0 0 5 )。血清中sICAM - 1对子宫内膜异位症的敏感性与特异性分别为 6 9 5 7%与 76 4 7%。血清sIL - 2R对子宫内膜异位症的敏感性与特异性分别为 6 5 2 2 %与 70 5 9%。血清中sICAM - 2R、sIL - 2R联合检测子宫内膜异位症的敏感性与特异性分别为 5 2 17%和 82 35 %。结论 血清中sICAM - 1、sIL - 2R可能与子宫内膜异位症的发生相关 ;检测血清中sICAM - 1与sIL - 2R有助于子宫内膜异位症的诊断和治疗 相似文献
3.
OBJECTIVE: We present a retrospective analysis of 22 cases of endometrioid ovarian carcinoma, reviewed to identify endometriosis and its malignant transformation. STUDY DESIGN: Twenty-two patients with endometrioid ovarian cancer were included in the review. Their clinical and histological data were retrospectively reviewed. The origin of the tumours was considered endometriosis-related when the presence of malignant changes in endometriosis glands leading to endometrioid carcinoma were found. RESULTS: Endometriosis was detected in three cases (3/22=14%). One of them presented a clearly benign to malignant transformation area. In another patient, the transition zone was abrupt and present in both ovaries. In the third, a pre-menopausal woman, ovarian endometriosis with only focal endometrioid carcinoma was observed. The three of them had a clear-cell carcinoma component. The presence of a clear-cell component was significantly greater in patients with endometriosis than in patients without endometriosis Each patient had a different clinical presentation: increase in abdominal perimeter, post-menopausal vaginal haemorrhage and hypermenorrhea. Preoperative CA 125 levels were avalaible in 15 of the patients (15/22=68%). Endometriosis was found in two of these 15 patients, both with the highest CA 125 measured levels, exceeding 1700 U/ml. In the remaining of the patients, CA 125 value did not exceed 35 U/ml. CONCLUSION: Although this association is not very frequent, patients with ovarian endometriosis and a high CA 125 serum level should be managed with special care, regardless of their pre-menopausal or post-menopausal status. 相似文献
4.
目的:探讨血清CA125水平与不同部位的子宫内膜异位症之间的相关性。方法:选择经手术或腹腔镜确诊的内异症患者63例和排除内异症的对照组30例,按内异症发生部位的不同分为3组:Ⅰ组(卵巢内异组)34例;Ⅱ组(阴道直肠隔内异组)15例;Ⅲ组(腹壁切口内异组)14例。Ⅳ组为对照组,系临床和病理检查排除了内异症的健康者。术前采取空腹静脉血,用化学发光法测定各组血清中CA125水平。结果:(1)卵巢内异组、阴道直肠内异组的血清CA125水平均显著高于对照组(P<0·05);腹壁切口内异组CA125水平显著低于卵巢内异组(P<0·05),而与阴道直肠隔内异症组、对照组比较无统计学差异(P>0·05);(2)以血清CA125≥35U/ml为临界值,CA125诊断各组内异症的敏感性分别为:卵巢内异症52·94%,阴道直肠内异症40·00%,腹壁切口内异症21·43%。诊断特异性为96·67%。结论:CA125在诊断子宫内膜异位症发生方面具有一定的价值,但并不是敏感指标。单凭血清CA125不能鉴别不同部位的子宫内异症。 相似文献
6.
目的:分析子宫内膜异位症患者合并子宫内膜息肉的情况,探讨血清CA125水平与痛经、内异症rAFS分期、病灶部位的相关性,为临床上更好地解读CA125水平提供依据。方法:回顾性分析2010年1月至12月我院术中或术后病理诊断为子宫内膜异位症的175例患者的临床资料。结果:(1)20.0%的子宫内膜异位症患者合并子宫内膜息肉;(2)36.6%的内异症患者有中、重度痛经,痛经程度与血清CA125水平无相关性;(3)Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期内异症患者的平均CA125水平分别为21.5U/ml、28.4U/ml、38.6U/ml、57.1U/ml,Ⅲ~Ⅳ期内异症患者血清CA125水平高于Ⅰ~Ⅱ期患者(P<0.05);(4)腹膜型、混合型、卵巢型内异症患者血清CA125的阳性率分别为21.4%、63.0%和67.4%,混合型、卵巢型内异症患者血清CA125阳性率显著高于腹膜型(P<0.001)。结论:血清CA125水平不能作为内异症合并子宫内膜息肉的预测指标;血清CA125水平可用于辅助鉴别内异症的分期和病灶部位,但是CA125对于内异症的早期诊断缺乏敏感性。 相似文献
7.
ObjectiveWe analyzed selected well-known and less well-known serum markers that have been proposed for diagnosis and severity assessment of endometriosis, in a case-control study. Study designThis prospective study was carried out in a Clinical Department of Gynecology in Iasi, Romania. Study participants included endometriosis patients, and controls in whom laparoscopy had excluded endometriosis. Each case and control was investigated for serum levels of CA125, TNF, IL-1, IL-6 and IL-8. The data were correlated with clinical symptoms and revised American Fertility Society (rAFS) score and stage, and interpreted by Mann-Whitney U-test and ANOVA regression analysis. ResultsOver the course of 1 year, 24 cases of endometriosis and 24 controls of matched age were selected. The rAFS stages were: stage I, 12.5%; stage II, 16.7%; stage III, 58.3%; and stage IV, 12.5%. CA125 levels were over the cut-off of 35 IU/l in 54% of patients (versus 8% of controls), averaging 67.5 (CI95: ±17.5). The sensitivity and specificity were 54% and 91%, respectively, with a p value of <0.001 (statistically significant). For IL-6, 71% of cases and 87% of controls were above the cut-off of 2 pg/ml, with an average of 11.83 ± 7. The sensitivity and specificity were 71% and 12%, respectively, but the difference was not statistically significant, p = 0.071. Other tested serum markers had no discrimination value. A correlation with severity of endometriosis was seen for CA125 ( p = 0.03) but not for IL-6, by ANOVA. ConclusionCA125 correlated with endometriosis screening and severity, indicating its superiority as a marker for further, larger studies. 相似文献
9.
目的:对联合测定子宫内膜异位症(内异症)患者血清中EMAb及CA125进行临床评价。方法:采取内异症109例术前(内异症组)和健康妇女30例(对照组)空腹静脉血,用酶联免疫吸附法(ELISA)测定两组血清中EMAb水平;用放射免疫法(RIA)测定血清中CA125水平。结果:内异症组EMAb阳性率为63.30%,对照组为10%,两组差异有显著性(P<0.05)。内异症各期及子宫腺肌病间EMAb阳性率差异无显著性(P>0.05)。内异症组血清CA125水平平均为70.70±16.62U/ml,对照组为15.38±5.32U/ml,两组差异有显著性。如以CA125≥35U/ml为阳性界值,则内异症组阳性率为80.23%,对照组为6.66%。单独测定EMAb诊断内异症的敏感性为63.30%,特异性为90%;单独测定CA125诊断内异症的敏感性为80.23%、特异性为93.33%。如以两者均阳性为诊断标准,则敏感性为57.80%,特异性为100%;如以其中之一阳性为诊断标准,则敏感性为91.74%,特异性为83.33%。结论:测定内异症患者血清中EMAb及CA125水平对内异症有较好的辅助诊断价值,联合测定EMAb及? 相似文献
10.
目的:探讨巨噬细胞移动抑制因子(macrophage m igration inhibitory factor,M IF)与子宫内膜异位症的发病及疾病进展的关系。方法:采用对照性临床研究。研究组为不同分期的子宫内膜异位症患者,对照组为行子宫切除术的子宫肌瘤患者:ELISA检测外周血中M IF的浓度,进行不成对的方差t检验,并与CA125浓度进行直线相关性分析;相对定量RT-PCR检测比较子宫内膜异位灶及正常在位子宫内膜组织中M IF的表达。结果:子宫内膜异位症患者外周血中M IF浓度比正常女性增加354%,子宫内膜异位症Ⅲ~Ⅳ期升高尤为显著。外周血中CA125浓度随着疾病的进展而升高,但是与M IF浓度之间无相关性。子宫内膜异位灶组织中M IF的表达较在位子宫内膜组织增强。结论:M IF与子宫内膜异位症的发生发展密切相关,提示M IF可能参与了子宫内膜异位症的发生发展过程,但是,外周血M IF浓度测定尚不能作为子宫内膜异位症的特异性和敏感性指标。 相似文献
11.
目的 探讨细胞间粘附分子-1(ICAM-1)在子宫内膜异位症发病机制中所起的作用。方法用免疫组织化学法检测子宫内膜异位症患者在位子宫内膜36例、异位子宫内膜36例及对照组子宫内膜30例ICAM-1的表达;并用酶联免疫吸附法检测子宫内膜异位症患者腹腔液47例、对照组腹腔液41例中sICAM-1的含量。结果①ICAM-1表达量的比较:子宫内膜异位症患者异位内膜〉对照组内膜〉子宫内膜异位症患者在位内膜;②子宫内膜异位症患者腹腔液sICAM-1含量明显高于对照组,P=0.0078;③Ⅰ,Ⅱ期和Ⅲ~Ⅳ期子宫内膜异位症患者腹腔液sICAM-1含量无明显差异,P=0.37。结论 ICAM-1的异常表达在子宫内膜异位症发病过程中起一定作用。 相似文献
12.
目的:研究端粒酶逆转录酶(hTERT)在子宫内膜异位症(EMs)在位内膜及异位内膜组织中的表达,探讨hTERT在EMs发生过程中的作用。方法:应用免疫组化SP法检测54例EMs患者及15例正常子宫内膜中hTERT的表达情况,应用显微镜及相关软件评估hTERT在EMs患者在位内膜及异位内膜组织中的表达,以及其随着月经周期变化的表达情况。分析子宫内膜异位病灶组织中hTERT表达与CA125、月经周期、r-AFs分期及年龄之间的相关关系。结果:EMs异位内膜病灶处hTERT表达水平显著高于在位内膜、正常子宫内膜(P0.05);EMs在位内膜显著高于正常子宫内膜(P0.05)。正常内膜和EMs在位内膜中,月经周期变化对hTERT的表达无明显影响。EMs病灶处hTERT的表达水平与血清中CA125水平呈正相关(r=0.367,P0.05),而与月经周期、r-AFs分期和年龄呈无明显相关性。结论:hTERT在EMs中异常表达,表明hTERT在EMs的发生过程中起着一定的作用。 相似文献
13.
Summary Due to its high specificity (90%) and sensitivity (86%) measurement of CA125 has become well-established in patients with
epithelial ovarian cancer. We have formulated a CA125 prognostic score and examined its validity as an additional prognosis
index. This score is composed of two CA125 values (one determined preoperatively and one 1 month after operation). CA125 serum
levels of 0–64 IU/ml received 1 point, levels of 65–299 IU/ml were given 2 points, and those >300 IU/ml were given 3 points.
These points are added to produce the CA125 prognostic score. Statistical comparison demonstrated that patients with scores
of 2 or 3 had a significantly ( P=0.0005) better prognosis than patients with scores of 4, 5 or 6. The classical prognostics features such as the FIGO stage,
residual tumor mass and ascites were found to correlate with the CA125 prognostic score. 相似文献
14.
OBJECTIVE: To investigate host immunologic response to endometriosis in terms of intercellular adhesion molecule (ICAM)-1 expression by macrophages and killer cell inhibitory receptor (KIR) expression by natural killer (NK) cells. DESIGN: Case-control study of immunologic markers. SETTING: University hospital. PATIENT(S): Twenty-eight Japanese women with endometriosis. Control subjects were 26 women without endometriosis. Diagnoses were made at laparoscopy. INTERVENTION(S): Venipuncture and laparoscopic peritoneal fluid collection. MAIN OUTCOME MEASURE(s): ICAM-1 expression by macrophages and KIR expression by NK cells, measured by flow cytometry. RESULT(S): In women with endometriosis, expression of ICAM-1 by peritoneal macrophages was significantly lower and expression of KIR by NK cells in peritoneal fluid and peripheral blood was significantly higher than in control subjects. CONCLUSION(S): Properties of macrophages and NK cells in women with endometriosis promote immunotolerance to implanted tissue in the peritoneal environment. Increased KIR(+)NK cells in peripheral blood may represent a risk factor for endometriosis. 相似文献
15.
目的 探讨地诺孕素治疗子宫内膜异位症对患者生殖激素、血清糖类抗原125(CA125)水平的影响.方法 选取90例子宫内膜异位症患者,按照随机数字表法分成甲组、乙组、丙组,每组30例.患者均实施腹腔镜下保留生育功能手术治疗,术后甲组给予口服地诺孕素6个月,乙组给予注射促性腺激素释放激素类似物(GnRHa)6个月,丙组给予... 相似文献
17.
Serum CA 125 was evaluated as a tumor marker in 85 patients with borderline ovarian tumors. Serum CA 125 levels were elevated preoperatively in 18 of 20 (90%) samples (median 66, range 5–272 U ml −1). Preoperative serum CA 125 levels did not correlate to FIGO stage. Preoperative serum CA 125 levels were elevated in seven of nine (78%) with serous tumors (median 131, range 5–272 U ml −1) and in all 11 with mucinous tumors (median 62, range 41–157 U ml −1). There was no significant difference in the CA 125 levels between these two histologic types. Postoperative serum CA 125 levels, measured 3–6 weeks after primary laparotomy, were significantly lower than the preoperative ones ( P < 0.001). No difference in the postoperative CA 125 levels was found between those with and those without residual disease after surgery. Postoperative serum CA 125 levels were elevated in eight of 60 (13%) without residual tumor. None of these had relapsed at the time of analysis (26–87 months after surgery). Serum CA 125 levels tended to correlate with disease evolution during chemotherapy. Two with disease remissions had falling levels, one with stable disease had falling level and one with disease progression had rising level. Serum CA 125 samples were obtained before second-look laparotomy in seven patients. Two with negative findings at second-look had normal levels. Of five with positive findings at laparotomy only two had elevated serum CA 125 levels. Disease relapse was associated with elevated serum CA 125 levels in only one of six patients. 相似文献
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